Diet, Activity, and Screen-time Behaviors Have Varied Associations with Sleep Indices Early in Life

Background: Sleep has been associated with diet, physical activity, and media exposure in older children, but little is known about how these obesogenic risk behaviors are associated during early life development. The objective of this analysis is to evaluate associations between obesogenic risk behaviors and sleep by age.Methods: Parent-reported data were evaluated from the Early Healthy Lifestyle (EHL) risk assessment for n = 10523 unique child entries collected from Geisinger pediatric care between 2016-2020. Chi-square tests were performed to test EHL response items across the population. Children were compared by age group (6-11 mo. only) and a television being on in the room where the child sleeps were each associated with bedtimes after 8 PM. Night waking (>2 times) was associated with breastmilk, low tummy time (12-24 mo. only). Night feeding was associated with high fat (>12-17 mo. only), breastmilk, low tummy time (18-24 mo. only).Conclusions: These population health findings display associations between early-life behaviors and sleep that vary by child age. These findings suggest that counseling and education strategies that target obesogenic risk behaviors may have collateral benefits for sleep hygiene, especially a television on in the sleep room which affected all ages studied.